REGISTRATION FORM

September 2014 June 2015

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432 Scotland Road, South Orange, NJ 07079
(973) 763-4600
cpaster@tstinj.org

Preschool Registration will open on:

January 3, 2014 Temple Members
January 6, 2014 Current Students and Siblings
January 10, 2014 Open Enrollment

4s Registration Form
NAME OF CHILD__________________________ SEX _____ BIRTHDATE:
AGE OF CHILD AS OF SEPTEMBER 2014 Years____________

Months______________

PARENT NAME:

BUSINESS PHONE:

PARENT NAME:

BUSINESS PHONE:

ADDRESS:
E-MAIL: _____________________________________________________________________
HOME PHONE: ____________________ ARE YOU A TEMPLE MEMBER? Yes [ ] No [ ]

Please select your program below:

[ ] 4 year old: 5 day Program
M, T, Th, F: 9:00 12:00 p.m.
W: 9:00 12:30 p.m.
Child must be four by October 1, 2014*
Temple Member $5,400
Non-Temple Member $6,950
Deposit required: $500
* Please note Kindergarten cut off in Maplewood/South Orange is October 1st.
**Enrichment Classes & Extension Programs are offered until 1:30 and/or 3:00pm each day. Please note, a separate enrichment
registration form will be sent, you are not registering for enrichment at this time.

After selecting your choice of program, please sign this form and enclose the required deposit. This
deposit will be applied to your childs tuition. Please make check payable to TSTI.
Mail to: Carol Paster, Iris Family Center, 432 Scotland Road, South Orange, New Jersey 07079.

Parent Signature:

Date: